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Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the upper genital tract, including the uterus, fallopian tubes, and ovaries. It happens when infections travel up from the vagina or internal genitals through the cervix.

PID can be cured with antibiotics.

Causes

The infections that cause PID can be passed through vaginal, oral, and anal sexual contact. This includes both penetrative sex and sexual activities where there is an exchange of body fluids or skin-to-skin contact. You can also get PID by sharing sex toys.  The most common infections that cause PID are chlamydia and gonorrhea.  It is also possible to get PID from infections that are not sexually transmitted.

Medical procedures that involve the cervix are the most common way for infections to travel to your upper genital tract and cause PID.  These procedures include: abortion, D&C (dilatation and curettage), and IUD (intrauterine device) insertion.  However, the infections can also pass through the cervix without a medical procedure having first occurred.

Symptoms

If you have PID, it is common to not notice any symptoms or to mistake your symptoms for a different illness. The most common symptom is pain in the lower abdomen, usually on both sides. The pain may be crampy or a dull constant ache and it may be worse during sex, or when you urinate or have a bowel movement. Other symptoms include:

  • fever or chills
  • nausea or vomiting
  • lower back pain
  • need to pee more often
  • abnormal vaginal discharge
  • abnormal vaginal bleeding or spotting between periods

Tests and Diagnosis

If you have symptoms of PID, your health care provider will do a pelvic exam and take swabs to test for sexually transmitted infections. They should also do a pregnancy test.  During this exam, your health care provider will feel for pain or tenderness in your lower abdomen.  Your health care provider may send you for an ultrasound.

It is best to get tested for PID if you have symptoms or have a partner who has tested positive for PID.

Treatment

PID is treated with prescription antibiotics. Occasionally, PID is severe enough to require hospitalization.  It is important to take all your medications as directed. If you miss any doses, your PID may not be cured.  See your health care provider if this happens or if you still have symptoms after you finish your treatment. If your symptoms get worse, seek immediate medical care (e.g., go to the hospital emergency).

It is important to not have sex (even with a condom) until you and your sexual partners have completed treatment.  If you do have sex during this time, you could pass the infection to your partners or get it again.  If this happens, talk to your health care provider.

Sexual Partners

Your sexual partners within the last two months should also be tested and treated. If you haven’t had sex in the last two months, your last partner should be tested and treated.

There are a few ways to tell partners. You can tell partners yourself or anonymously. Talk to your health care provider about what is right for you.

Complications

PID can lead to serious complications such as:

  • long lasting pelvic pain
  • recurrent PID
  • trouble getting pregnant (infertility)
  • increased chance of a tubal pregnancy (the egg attaches outside of the uterus)
  • Fitz-Hugh-Curtis syndrome - a rare complication affecting the liver

Recurring infections are common and they increase the chance of long-term health problems. The risk of these complications increases each time that you have PID.  Recurring infections can be caused by:

  • inadequate treatment of the first infection
  • failure to treat sexual partners

Prevention

It is a good idea to be tested regularly for STIs, especially if you have new sexual partners or open relationships.  Talking with partners about safer sex makes sure everyone knows what to expect.  Condoms are great if they work for you – the correct use of condoms reduces your chances of getting and passing the bacteria that can cause PID.

Resources

HealthLink BC – Information about PID in multiple languages
SmartSexResource – If you are worried or have anxiety about PID
Trans Care BC – Gender-affirming sexual and reproductive health information


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